Posterolateral transforaminal selective endoscopic diskectomy with thermal annuloplasty for discogenic low back pain: a prospective observational study.

STUDY DESIGN

A prospective observational study on 113 patients with 3 years of follow-up.

OBJECTIVE

To evaluate the clinical results of therapy for discogenic low back pain (DLBP) with posterolateral transforaminal selective endoscopic diskectomy and thermal annuloplasty (PEDTA).

SUMMARY OF BACKGROUND DATA

Currently, various minimally invasive techniques are widely used to treat chronic DLBP with variable clinical outcomes. PEDTA is considered to be a novel, minimally invasive technique for treating chronic DLBP, but the evidence supporting this technique is very limited, and there are no studies demonstrating at least 3 years of follow-up.

METHODS

One hundred thirteen consecutive patients with DLBP with positive concordant pain in discography underwent PEDTA from March 2008 to March 2010. These patients included 64 males and 49 females with a mean age of 43.7 years (range, 16-75 yr). The visual analogue scale score, Japanese Orthopedic Association score, and Oswestry Disability Index were evaluated before therapy and each year after surgery. The clinical global outcomes were assessed on the basis of modified MacNab criteria at 3 years after surgery.

RESULTS

Ninety-six patients underwent a single-level procedure, and 17 patients underwent multilevel procedures. One hundred one (89.4%) cases were followed up for 3 years. There were no serious complications observed during follow-up. The success rate (excellent and good) was 73.8%. The visual analogue scale score, Japanese Orthopedic Association score and Oswestry Disability Index had significantly improved at each year after surgery (P < 0.01, compared with presurgery). The success rate in patients who underwent a single-level procedure was remarkably higher than that in patients who underwent multilevel procedures (78.2% vs. 50.0%, P = 0.041).

CONCLUSION

PEDTA presents a safe and effective treatment for carefully selected groups of patients with DLBP. Better clinical results occurred in patients with single-level discogenic pain.